Homonegative Attitudes and Risk Behaviors for HIV and Other Sexually Transmitted Infections Among Sexually Active Men in the United States

Objectives. We examined associations between homonegative attitudes and HIV and other sexually transmitted infection (HIV/STI) risk behaviors among sexually active US men. Methods. We used the 2006-2010 National Survey of Family Growth (n = 10 403) and multivariable logistic regression models to examine homonegative attitudes in relation to condom use, number of past-year sex partners, HIV/STI testing, and STI diagnoses. Results. Among men who had sex with men, homonegative attitudes were associated with lower odds of condom use during anal sex with women (before the past year) and past-year STI testing. Among men who had sex with men and women, homonegative attitudes were associated with lower odds of condom use during vaginal sex and sex with men, having 4 or more partners, and HIV testing ever. Among men who had sex with women, homonegative attitudes were associated with lower odds of condom use during vaginal sex and sex with men (before the past year), HIV testing ever, and contracting herpes, human papillomavirus, or syphilis. Conclusions. Homonegative attitudes may promote HIV/STI acquisition and transmission among sexually active men of all sexual orientations. Interventions should address homonegative attitudes in the United States.